Mitchell J, Schulman H, Fleischer A, Farmakides G, Nadeau D
Obstet Gynecol. 1985 Mar;65(3):352-5.
Meconium in labor is associated with increased perinatal morbidity and mortality. To identify the infants at risk, 53 women with moderate-to-thick meconium were followed in labor after obtaining baseline fetal scalp blood pH levels. Although 28 of the newborns (53%) exhibited an arterial cord pH of less than 7.25 at delivery, there were no significant predictive variables found in the electronic fetal monitoring score, Apgar score, or mode of delivery. Nine of the infants with a pH value of less than 7.25 had meconium below the vocal cords at delivery, but none in the infants with pH levels greater than or equal to 7.25. The P50 value for cumulative acidosis is 55 minutes, indicating a more rapid deterioration than an average-for-gestational-age fetus without meconium. Therefore, the presence of thick meconium implies that fetal stress must be avoided during labor, and early intervention is warranted when there is deviation from normal labor progress or fetal heart rate pattern.
产时胎粪与围产期发病率和死亡率增加相关。为了识别有风险的婴儿，对53名有中度至浓稠胎粪的妇女在获得基线胎儿头皮血pH值水平后进行产时跟踪。尽管28名新生儿（53%）在分娩时脐动脉血pH值低于7.25，但在电子胎儿监护评分、阿氏评分或分娩方式中未发现显著的预测变量。9名pH值低于7.25的婴儿在分娩时声带以下有胎粪，而pH值大于或等于7.25的婴儿中则没有。累积酸中毒的P50值为55分钟，表明其恶化速度比无胎粪的同孕周平均胎儿更快。因此，浓稠胎粪的存在意味着产时必须避免胎儿窘迫，当产程或胎心率模式偏离正常时，有必要进行早期干预。
